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What Is Medical Underwriting?

Are you considering a Medicare Supplement plan? You might need one if you are looking for ways to fill the gaps in your Original Medicare coverage. If your Medigap Open Enrollment period has passed, then you may be subject to undergo medical underwriting. This is a crucial step to get an approved plan.

Additionally, if you are switching from a Medicare Advantage plan to a Medicare Supplement plan, or if you are switching from one Medicare Supplement plan to another, this may be another scenario in which you might have to undergo medical underwriting. While it may seem like a temporary inconvenience, this process might allow you to find a plan that is better for you – and might save you money.

What Is Underwriting?

Medical underwriting is the process where private insurance companies collect information about your medical history and physical and mental health. Insurance companies use this information to determine your cost for coverage and whether to approve or deny your application.

Typically, those with an extensive history of medical issues might have to pay more for their coverage. You might not even be approved for coverage in these situations. Pre-existing conditions will also be brought up during the underwriting process. Companies may issue a waiting period for coverage if you have one of these conditions, or you may be denied entirely.

When Do I Need Underwriting?

If you are trying to enroll in a Medicare Supplement plan and your Medigap Open Enrollment period has passed, you may have to go through medical underwriting. Additionally, as mentioned before, if you are trying to switch Medigap plans, this is another situation in which you might have to go through the underwriting process.

If you are still in your Medigap Open Enrollment period, this gives you a “guaranteed issue right.” This means that you can purchase any Medigap plan in your coverage area, and the insurance companies cannot deny you for any reason related to your health history. Because of this, medical underwriting is not needed during this time.

What Happens During the Underwriting Process?

Every insurance company has different applications for its Medicare Supplement plans. These applications have an extensive list of health questions. These health questions will cover your entire medical history. This includes any health problems you have ever had or ones that you currently have.

Having any of the health conditions that is asked about could potentially create a case for automatic denial of your application. Some examples include any major health conditions that may be expensive for the insurance company to cover. These include any chronic or incurable health problems.

There are also certain medications that could deny your application. Like denied applications for chronic or incurable illnesses, these medications often treat chronic or incurable illnesses. Often times, these medications are expensive for carriers to treat, making it look less attractive on applications.

How to Avoid Underwriting

If you have any major health conditions, it might behoove you to avoid the underwriting process. This is possible to do. If you enroll in a Medicare Supplement plan during your Medigap Open Enrollment period, the law requires that your acceptance in a plan must happen. For example, if you have any pre-existing condition, or if you are a smoker, this Medigap Open Enrollment period is a crucial time for you to enroll in a Medigap plan. This is because companies cannot turn you down or charge you more for your health conditions.

Your Medigap Open Enrollment Period lasts for six months. It starts when you are 65 and enrolled in Medicare Part B.

Nothing on this website should ever be used as a substitute for professional medical advice. You should always consult with your medical provider regarding diagnosis or treatment for a health condition, including decisions about the correct medication for your condition, as well as prior to undertaking any specific exercise or dietary routine.

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